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How Medicaid expansion keeps winning

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How Medicaid expansion keeps winning


Six instances since 2017, voters in a state have weighed in instantly on whether or not to increase Medicaid and make extra low-income adults eligible without spending a dime public well being protection. Six instances, the poll measure has handed.

That undefeated streak may lengthen to seven wins in South Dakota this November.

On Election Day, voters will resolve on a constitutional modification that will lengthen Medicaid eligibility underneath the Inexpensive Care Act. If it passes, anyone making lower than 133 p.c of the federal poverty stage (about $18,000 for a person or $36,900 for a household of 4) would qualify for Medicaid protection. Proper now, 5 p.c of the state is uninsured. Childless adults of working age can’t qualify for protection in any respect. Pregnant girls, kids, and the aged can presently obtain Medicaid advantages, however working dad and mom will need to have a really low revenue — lower than 63 p.c of the federal poverty stage, about $17,500 for a household of 4 — to enroll.

An estimated 45,000 South Dakotans can be coated by the enlargement, including to twenty.4 million low-income Individuals nationwide already insured by the Medicaid enlargement for the reason that program took full impact in 2014. Lots of those that would qualify for Medicaid in South Dakota — about 14,000 — are Native Individuals presently ineligible for protection. The poll initiative seems to have a very good shot at passing in November: Polling commissioned by the American Most cancers Society Most cancers Motion Community discovered 62 p.c of South Dakota voters mentioned they help the measure.

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Initially, the Inexpensive Care Act was meant to increase Medicaid protection to low-income adults nationwide. The legislation provided a very good deal: increase eligibility and obtain a beneficiant federal funding match, 90 p.c of the price in perpetuity. However a 2012 Supreme Courtroom resolution made Medicaid enlargement non-obligatory for states, and a dozen states nonetheless haven’t accepted the enlargement a full decade later, leaving 4 million folks with out Medicaid protection who would in any other case be eligible.

Within the face of that obstruction from Republican state officers, well being care advocates have taken the difficulty on to voters in largely Republican states, with exceptional success.

Throughout the six states which have expanded Medicaid via a poll measure — Idaho, Maine, Missouri, Nebraska, Oklahoma, and Utah — an estimated 811,000 folks have both enrolled or change into eligible for Medicaid protection. It’s a brand new frontier for increasing entry to medical health insurance in America. I requested Paul Starr, a Princeton College sociologist and the preeminent historian of the American well being system, whether or not there was any precedent for direct democracy resulting in important protection expansions.

“The historical past of medical health insurance safety till the Supreme Courtroom’s resolution on the ACA in 2012 was virtually totally a historical past of laws and administrative choices,” he instructed me. “Poll measures weren’t very important.”

However poll initiatives have change into, in the previous couple of years, virtually completely the trail for Medicaid enlargement to maintain advancing. Within the first few years after the Supreme Courtroom’s resolution, a lot of Republican state leaders determined to undertake Medicaid enlargement on their very own, pushed by the monetary advantages and lobbying from native well being care teams. The Obama administration accepted waivers — together with one from future Vice President Mike Pence, then governor of Indiana — to tweak this system to make it extra amenable to those GOP politicians.

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However by 2017, with Donald Trump coming into the White Home, the prospects for future motion by Republican governors and legislatures regarded grim. So the Equity Challenge, an offshoot of an SEIU well being care employees union in California that was supporting minimal wage poll initiatives on the time, began coordinating with native organizers to place Medicaid enlargement instantly on the poll.

“Direct democracy has been a path for essential change and likewise a path of final resort,” Kelly Corridor, a former Obama administration well being official who’s now the manager director of the Equity Challenge, mentioned. “Increasing Medicaid anyplace helps defend it in all places.”

The previous few years have been a revelation of Medicaid’s political efficiency. Considerations about ending the enlargement and slicing Medicaid spending helped doom the Republican plans to repeal and substitute the ACA. And these six enlargement poll initiatives have all handed since 2017, with South Dakota poised to change into the seventh.

Corridor mentioned the marketing campaign’s objective has been “serving to to put Medicaid alongside the opposite third rail public packages like Medicare and Social Safety.”

“Medicaid has a a lot wider base of help than many individuals admire,” Starr instructed me. “It’s not simply the poor who profit. It’s additionally folks with disabilities and seniors, plus their households and the suppliers that profit from Medicaid fee.”

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GOP leaders have nonetheless tried — unsuccessfully up to now — to cease or subvert these poll initiatives, first in Utah and Missouri, and now in South Dakota. For the first election in June, the state legislature put up a poll measure that will have required a 60-percent supermajority for any future poll initiatives to be adopted, with the intent of constructing it tougher for the Medicaid enlargement measure to go. However it was rejected by two-thirds of South Dakota main voters.

Why does Medicaid enlargement maintain discovering success with red-state voters, if not their elected representatives? Corridor pointed to 3 profitable messages: listening to from neighbors who will profit, bringing federal tax {dollars} again to the state, and defending the solvency of rural hospitals and well being clinics. One of many adverts operating in South Dakota contains a farmer who says he desires to maintain his household farm operating however can’t afford well being care proper now.

Thus far, Medicaid enlargement poll initiatives have been an unqualified success. However their usefulness would possibly quickly be operating out. Solely about half of states permit citizen-initiated poll measures and, of the 12 states that haven’t expanded Medicaid, solely 4 of them allow such initiatives: South Dakota — which is already voting on it this fall — plus Florida, Mississippi, and Wyoming.

Florida is the second greatest state, after Texas, that’s nonetheless refusing Medicaid enlargement. These two states are house to greater than half of the two.2 million folks nationwide who’ve been left and not using a viable possibility for protection as a result of their state has not expanded Medicaid. However whereas poll initiatives are permitted there, they require a 60-percent supermajority and the state legislature has proven a willingness to undermine poll measures after their passage.

Your complete Mississippi poll initiative course of, in the meantime, was upended by a state courtroom resolution in 2021; advocates are working to revive the rights of residents to gather signatures and put points on to voters. In Wyoming, there may be some hope that the legislature and governor might but get on board with Medicaid enlargement because the state faces funds woes.

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So whereas poll measures may nonetheless make extra good points in increasing Medicaid protection, enlargement advocates are operating out of alternatives. Texas, for instance, is among the states that doesn’t permit citizen-sponsored poll initiatives. Neither do Georgia or North Carolina, the subsequent greatest states after Florida to not increase it.

“We’re fairly near working ourselves out of a job on this subject,” Corridor mentioned.

However the work will nonetheless be unfinished, till Republicans in these different states come round, Democrats can win in statewide elections, or Congress decides to take motion to shut the Medicaid enlargement hole for good.



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South Dakota

USD Department of Art Instructor Hosted Arts and Health Program at Mike Durfee State Prison

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USD Department of Art Instructor Hosted Arts and Health Program at Mike Durfee State Prison


Ariadne Albright, an arts in health adjunct instructor in the University of South Dakota Department of Art, co-directed an arts and health program at the Mike Durfee State Prison in Springfield.

The program, I Believe II / The South Dakota Prison Project, was led by Albright and Suzanne Costello, director of the Stuart Pimsler Dance & Theatre Company. It was a sequel to the successful 2022-2023 initiative at the South Dakota State’s Men’s Penitentiary in Sioux Falls.

Funded by a South Dakota Department of Health Innovation Grant, the intensive two-week residency included four hours of daily workshops in visual arts, writing, movement and theater, exploring personal beliefs and fostering self-expression. The project culminated in an art exhibit and performance.

“The goals of this innovative program are to positively impact barriers prevalent in carceral settings, promote mental wellness through creative expression and provide tools for personal growth,” Albright said. “Further, this initiative seeks to foster connections and empathy among this community, impacting greater prison culture.”

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The I Believe I & II projects extend beyond the prisons and into the community. The artwork created during the residencies will be showcased in a touring art exhibit, Arts & Incarceration, to museums and galleries across South Dakota and Minnesota from 2024-2026. These exhibitions will include gallery talks to facilitate dialogue and understanding for audiences outside the prisons.



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Navajo leaders outraged after a Lakota student’s tribal regalia was removed at graduation • South Dakota Searchlight

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Navajo leaders outraged after a Lakota student’s tribal regalia was removed at graduation • South Dakota Searchlight


Graduation season is typically a time for celebrating the success of students making it through their education programs.

For some Indigenous students, part of that celebration includes having tribal regalia or objects of cultural significance as part of their cap and gown during the graduation ceremony.

In Arizona, Indigenous students are protected under state law. In 2021, then-Gov. Doug Ducey signed House Bill 2705 into law, barring public schools from preventing Indigenous students from wearing traditional tribal regalia or objects of cultural significance at graduation ceremonies.

Not all states have similar laws to protect Indigenous students. New Mexico’s lawmakers say they passed legislation to prevent incidents like this from occurring, but it’s now unclear if that applies to a case garnering attention in Farmington, New Mexico.

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On May 13, Genesis White Bull, a Hunkpapa Lakota of the Standing Rock Sioux tribe, was standing for the national anthem alongside her graduating class at the Farmington High School graduation ceremony when two unidentified school faculty members approached her to confiscate her graduation cap.

In video footage shared across social media, White Bull is seen being instructed to remove her graduation cap, which was embellished with an eagle plume and beaded around the rim.

Brenda White Bull, Genesis’ mother, shared the experience with the Navajo Nation Council and reported that school officials later cut the plume from her daughter’s cap using scissors.

The Navajo Nation Council stated in a press release that Brenda emphasized the sacred significance of the plume, which symbolizes achievement and cultural identity, marking Genesis’ transition into new phases of her life.

The Arizona Mirror contacted the family for an interview, but the family did not respond before publication.

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‘No place for this type of behavior’

Navajo Nation Council Speaker Crystalyne Curley called Farmington High School’s actions “belittling, humiliating, and demeaning to the student and her family.

“There is no place for this type of behavior in our educational systems,” Curley said in a press release. “The school officials owe an apology to the student and her family.”

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Farmington Municipal Schools, which oversees Farmington High School, released a statement on May 15 in response to the incident.

“During the event, a student’s beaded cap was exchanged for a plain one. The feather was returned intact to the family during the ceremony,” Farmington Municipal Schools wrote in the statement. “The beaded cap was returned after graduation concluded.”

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Farmington Municipal Schools referred to the district’s protocols, which state that graduation caps and gowns can not be altered, per the 2023-2024 Student and Parent Handbook.

The handbook does not contain policy language stating any exceptions to these rules. However, the school’s statement noted that students could choose their clothing attire, which included traditional attire to be worn under the graduation cap and gown, regalia, stoles, and feathers in their tassels.

“Students were informed throughout the school year and immediately before graduation of the protocol, including that beaded caps were not allowed,” the statement read. “This standard process helps us set student attire during graduations.”

“While the staff involved were following district guidelines, we acknowledge this could have been handled differently and better,” the statement read. “Moving forward, we will work to refine our processes at the school level.”

Farmington Municipal Schools stated that the district is also committed to exploring policies that allow for additional appropriate cultural elements in student attire. Indigenous students comprise nearly 34% of the school district’s population.

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“School officials across the country need to be reminded who the first Americans are and whose land they inhabit,” Curley said in a press release. “No student in any school should be prohibited from wearing regalia that signifies their cultural and spiritual beliefs.”

Law under review

New Mexico passed an anti-discrimination law in 2021 that might protect students against the Farmington schools district policy.

However, the legal pathway is unclear according to responses from spokespeople in the governor’s offices, state education department, and even lawmakers who wrote the recent law.

Each acknowledged that they were reviewing the law and could only give an official opinion once that was completed. Requests for comment were made to the New Mexico Department of Justice but were not returned in time for publication.

Sen. Harold Pope (D-Albuquerque), who co-sponsored the law, said the legislation stemmed from the national Crown Act push that targeted to stop policies that discriminate against hair style and texture, with a significant tilt against African Americans.

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New Mexico’s version was written from the views of the Native American cultures present throughout the state, Pope said, and the bill included co-sponsors who are Dińe and Jemez Pueblo.

“We wanted to make sure that we included cultural and religious headdresses to be even more inclusive than your hair alone,” he said. “And what I think is important in that language, when we look at Indigenous cultures, feathers are so cherished and protected and it is part of who they are.”

It’s unclear now if the law will provide White Bull support for any legal action she could take against Farmington Municipal Schools District.

‘It broke my heart’

After footage of White Bull’s graduation experience spread on social media, it sparked an outpouring of support from Indigenous people and communities across the country.

Navajo Nation leaders have voiced their support for White Bull and called for schools to support an Indigenous student’s right to wear regalia during their graduation ceremonies, saying denying it is a violation of their rights.

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“It broke my heart,” Navajo Nation Council Delegate Amber Crotty told the Arizona Mirror when she learned what happened to the student.

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Crotty said graduations are meant to be one of the happiest moments of a student’s life, and White Bull’s experience was tarnished by having something so important taken away from her.

“That’s so traumatic and not the best way to approach these situations when it comes to our Native students,” Crotty said. “In a day of celebration, just for her to be attacked like that.”

Crotty said the incident has been reported to the Nation Human Rights Commission, which investigates discrimination within border towns.

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Farmington borders the Navajo Nation, and there is a documented history of racism against Indigenous people living or visiting the city.

In April 1974, three white Farmington High School students brutally murdered four Navajo men as part of a practice locals called “Indian rolling.”

In response to the murders, Navajo and other Indigenous people held protests in the city of Farmington denouncing the pervasive racism and bigotry of the community.

Due to escalating tensions in Farmington, the New Mexico Advisory Committee to the U.S. Commission on Civil Rights launched a study of the relationships between the city, San Juan County and the Navajos living in the community and on the Navajo Nation.

The committee concluded that Indigenous people in almost every area suffer from injustice and maltreatment, according to their report. They recommended that city officials and San Juan County officials, in conjunction with Navajo leaders, work together to develop a plan of action to improve the treatment of Navajos living in the border areas of northwestern New Mexico.

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The advisory committee conducted another report 30 years later and found that, while race relations may have somewhat improved in the area, racism is still an issue within the city of Farmington.

“There is a lack of understanding of how Native students identify themselves and celebrate themselves,” Crotty said.

She said that it is time to move beyond having conversations about cultural sensitivity for Native students, mainly because incidents like this keep occurring.

“That’s why we want to support mom and the family,” Crotty said. “She does want the school to be accountable, and she does want some sort of apology.”

Crotty said the staff’s actions at Farmington High School were inappropriate, and immediate action is needed rather than the school trying to justify what happened.

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“The cultural identity of all Native American students attending Farmington High School are protected under the New Mexico Indian Education Act,” she said, adding that what happened was a clear violation of the student’s rights.

“As we move forward in addressing this issue, we will be meeting with the school board and administration,” Crotty added.

In New Mexico, the law passed in 2021 is directed specifically to local school districts, but it does not allow the New Mexico Public Education Department to issue any statewide order on local issues, such as what students can wear at graduation ceremonies.

New Mexico’s 89 school districts decide on those policies, which is why other Indigenous students across the state have different experiences with graduation attire.

New Mexico’s Public Education Secretary, Dr. Aresenio Romero, offered support for White Bull but noted that the issue is the responsibility of the local district.

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“I expect the Farmington Superintendent and school district to reevaluate their graduation policies,” Romero said. “I remain committed to promulgating tribal sovereignty and to respecting tribal cultural customs and practices.”

Governor issues statement

Gov. Michelle Lujan Grisham issued a statement Friday saying that it was unacceptable that a student was reprimanded for representing their culture during a time of celebration.

“I appreciate that the Farmington schools acknowledge that they could have handled this situation better and that their policy may be too restrictive,” she added. “However, it shouldn’t have required the student raising this issue for a school to recognize its lack of inclusivity.”

Navajo Nation First Lady Jasmine Blackwater-Nygren released a statement supporting Indigenous graduating students who wear their cultural and traditional regalia during graduation.

“We stand with our Native graduates this graduation season and their decision to wear their traditional tribal regalia or objects of cultural significance, including eagle feathers, eagle plumes, and beaded graduation caps,” Blackwater-Nygren said in a statement she posted on her Facebook. “Our graduates and families take immense pride in what they choose to wear on graduation day.”

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Blackwater Nygren was a guest speaker at the Farmington High School graduation, but she said she was unaware of what occurred until after the graduation.

“I am deeply disappointed that this happened at a school where we have many Navajo and Native graduates,” she said. “I hope the school learns from this experience and can take corrective measures.”

Blackwater-Nygren said that, for many Indigenous students, deciding what to wear goes far beyond simply deciding what color dress or shoes to wear. For some Indigenous students, it is a day for them to wear their traditional regalia proudly.

“Our regalia reminds us of how far we’ve come as a people; it shows our pride in our culture and how we chose to identify ourselves as Native people,” she said. “Some graduates are the first in their families to graduate or are only one of a few high school graduates in the family. A beaded cap further signifies this symbol of achievement, accomplishment and Native resilience.”

Blackwater-Nygren is familiar with this issue because, as an Arizona State Representative, she helped pass House Bill 2705 through the legislature.

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“As graduation season continues, I hope all schools will respect the decision of our Native students to wear their traditional regalia and objects of cultural significance,” Blackwater-Nygren said.

This story was originally published by the Arizona Mirror and Source New Mexico. Like South Dakota Searchlight, they’re part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Source New Mexico maintains editorial independence. Contact Editor Shaun Griswold for questions: [email protected]. Follow Source New Mexico on Facebook and Twitter.





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More than half of states sue to block Biden Title IX rule protecting LGBTQ+ students • South Dakota Searchlight

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More than half of states sue to block Biden Title IX rule protecting LGBTQ+ students • South Dakota Searchlight


WASHINGTON — Twenty-six GOP-led states are suing the Biden administration over changes to Title IX aiming to protect LGBTQ+ students from discrimination in schools.

Less than a month after the U.S. Department of Education released its final rule seeking to protect against discrimination “based on sex stereotypes, sexual orientation, gender identity, and sex characteristics,” a wave of Republican attorneys general scrambled to challenge the measure.

The revised rule, which will go into effect on Aug. 1, requires schools “to take prompt and effective action when notified of conduct that reasonably may constitute sex discrimination in their education programs or activities.”

The lawsuits hail from Alabama, Alaska, Arkansas, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia and Wyoming.

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All of the attorneys general in the 26 states suing over the final rule are part of the Republicans Attorneys General Association.

Various advocacy groups and school boards have also tacked onto the states’ legal actions. The lawsuits carry similar language and arguments in vehemently opposing the final rule. They say the new regulations raise First Amendment concerns and accuse the rule of violating the Administrative Procedure Act.

LGBTQ+ advocates say the revised rule offers students a needed protection and complies with existing law.

“Our kids’ experience in schools should be about learning, about making friends and growing as a young person. LGBTQ+ students deserve those same opportunities,” Sarah Warbelow, vice president of legal at the LGBTQ+ advocacy group Human Rights Campaign, said in an emailed statement. “In bringing these lawsuits, these state attorneys general are attempting to rob LGBTQ+ students of their rights, illustrating a complete disregard for the humanity of LGBTQ+ students.”

GOP states band together against new regulations

In the most recent effort, Alaska, Kansas, Utah, and Wyoming sued the Biden administration on Tuesday, accusing the Department of Education of seeking to “politicize our country’s educational system to conform to the radical ideological views of the Biden administration and its allies.”

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The lawsuit claims that under the updated regulations, teachers, coaches and administrators would have to “acknowledge, affirm, and validate students’ ‘gender identities’ regardless of the speakers’ own religious beliefs on the matter in violation of the First Amendment.”

In another lawsuit, a group of Southern states —  Alabama, Florida, Georgia and South Carolina — sued the administration in federal court in Alabama over the new regulations.

Republican Alabama Attorney General Steve Marshall said President Joe Biden “has brazenly attempted to use federal funding to force radical gender ideology onto states that reject it at the ballot box” since he took office.

“Now our schoolchildren are the target. The threat is that if Alabama’s public schools and universities do not conform, then the federal government will take away our funding,” Marshall said in a press release.

The lawsuit also drew praise from Republican Florida Gov. Ron DeSantis, who said “Biden is abusing his constitutional authority to push an ideological agenda that harms women and girls and conflicts with the truth.” He added that the Sunshine State will “not comply” and instead “fight back against Biden’s harmful agenda.”

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Individual states sue the administration 

Meanwhile, some states have opted to file individual lawsuits against the administration.

In Texas, Republican Attorney General Ken Paxton sued the Biden administration late last month in federal court in Amarillo. Paxton filed an amended complaint earlier this week, with two new plaintiffs added.

In an April 29 press release, Paxton said the Lone Star State “will not allow Joe Biden to rewrite Title IX at whim, destroying legal protections for women in furtherance of his radical obsession with gender ideology.”

Oklahoma’s Republican Attorney General Gentner Drummond filed a lawsuit against the Biden administration earlier this month in federal court in Oklahoma. The state’s education department also filed a separate suit against the Biden administration.

A hodgepodge of states 

In late April, Republican attorneys general in Indiana, Kentucky, Ohio, Tennessee, West Virginia and Virginia filed a lawsuit against the Biden administration in federal court in Kentucky.

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The states argued that the U.S. Education Department “has used rulemaking power to convert a law designed to equalize opportunities for both sexes into a far broader regime of its own making.”

Idaho, Louisiana, Mississippi and Montana also sued the Biden administration in late April, echoing the language seen in the other related lawsuits. Seventeen local school boards in Louisiana also joined the states.

Earlier this month, Arkansas, Iowa, Missouri, Nebraska, North Dakota and South Dakota also brought a collective legal challenge to the final rule.

A spokesperson for the Education Department said the department does not comment on pending litigation but noted that “as a condition of receiving federal funds, all federally-funded schools are obligated to comply with these final regulations.” They added that the department looks forward “to working with school communities all across the country to ensure the Title IX guarantee of nondiscrimination in school is every student’s experience.”

The department has yet to finalize a separate rule that establishes new criteria for transgender athletes. So far, 24 states have passed laws that ban transgender students from partaking in sports that align with their gender identity, according to the Movement Advancement Project.

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